Ground-breaking study to set new roadmap for HIV services in Papua New Guinea

Port Moresby, 25 January 2018: A ground-breaking study into HIV and STIs in Port Moresby has been praised by the Minister for Health, Hon Sir Puka Temu and by the Government’s key Health partners. The findings of the study provide an improved roadmap for treatment, care and provision of other services to key populations affected by HIV in the country.

The study, called Kauntim mi tu, was initiated by the National Department of Health and the National AIDS Council Secretariat, with funding support from the Government of Australia, the Global Fund to Fight AIDS, TB and Malaria, and the US Centers for Disease Control and Prevention. Contributions for the study were also received from Cepheid, FHI360, Oil Search Foundation, Population Services International and the World Health Organization. Funding for Kauntim mi tu was administered by Oil Search Foundation, in its role as Global Fund HIV Principal Recipient for Papua New Guinea.

The study was undertaken by the PNG Institute of Medical Research and collaborating research partners, and led by Dr Angela Kelly-Hanku and Mr Avi Hakim, with technical support from the Kirby Institute, UNSW Sydney, Australia and the US Centers for Disease Control and Prevention.

Kauntim mi tu studied women and girls who sell and exchange sex (FSWs), and men who have sex with men and transgender women (MSM/TG). It was conducted to support the scale up of essential HIV prevention and treatment services for these populations. The Port Moresby study involved 674 FSWs and 400 MSM/TGs.

Some of the key findings from the study include the following:

HIV prevalence among FSWs in Port Moresby was 14.9% and most do not know their HIV status;

Prevalence of sexually transmitted infections (STI) was high and 52.1% of FSWs had at least one STI (excluding HIV);

Only 32.7% of FSWs used condoms with all clients who gave money in the last six months;

More than half of FSWs (57.3%) have experienced physical violence and 34.2% have been forced to have sex. Approximately one in five experienced violence from their clients in the last six months;

HIV prevalence among MSM and TGs in Port Moresby was 8.5% with few knowing that they have HIV;

Prevalence of STIs was high among MSM and TGs with 34.0% having at least one STI (excluding HIV);

Of these individuals, 59.1% did not use a condom at last sex with this kind of partner; and

More than half of MSM and TGs (58.5%) have experienced physical violence and 24.1% have been forced to have sex. Of those experiencing physical violence in the last 12 months, 8.9% of survivors believed it was related to their sexual behaviours or sexual identity. Almost all MSM and TGs (90.4%) did not seek support after an experience of sexual violence.

The study, the first of its kind in the country and a global first – providing up to eight point-of-care tests at the study site – drew praise from the Government and other partners who were involved. Importantly, members of the peer-led civil societies representing FSW (Friends Frangipani) and MSM/TG (Kapul Champions) also praised the study team in light of the comfort and confidentiality emphasized in the study. The following are some quotes from key partners involved in the study:

Hon Sir Puka Temu, Minister for Health and HIV/AIDS: “This study will contribute to the country’s understanding of the national HIV and STI epidemics for years to come. It will provide better-focused information for policymakers, implementers, service providers, and donors. The Government wishes to thank the Australian and US Governments and the Global Fund for funding this important study. We can also be very proud of the role played by the PNG Institute of Medical Research in leading the study.”

Dr Kelly-Hanku, Kauntim mi tu Principal Investigator: “Kauntim mi tu provides not only the first size estimation of women who sell and/or exchange sex and men who have sex with men in Port Moresby, but also the most representative biobehavioural data about these key populations to date. It was breaking globally for a study of this kind, providing same day STI testing and treatment.”

Mr Tony Lupiwa, Oversight Manager, National AIDS Council Secretariat: “FSW, MSM and TG are a part of our community and must have their human rights protected, as outlined in our constitution where we are all equal. This study highlights their plight and need for acceptance. It also highlights the needs for enhanced HIV, health, and social services for FSWs, MSM and TGs.”

Mr David Bridger, UNAIDS Country Director: “While the AIDS response in Papua New Guinea has made substantive gains, the epidemic is far from over. Kauntim mi tu provides critical data for government and stakeholders alike to ensure that HIV programming reaches the right people in the right place at the right time. This will be essential if Papua New Guinea is to realise its commitment to end AIDS as a public health threat by 2030.”

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